Operation Smile: One Physician Recruiter’s Mission Experience

Little did I know when I picked up an employee newsletter in the break room at work in the spring of 1998 advertising the need for volunteers for upcoming medical missions to Venezuela and Morocco, how profoundly I would be impacted, and what a big part of my life medical mission work would become. I responded to the advertisement and learned that the missions were with a group called Operation Smile that provides free reconstructive surgery to children and adults born with facial deformities such as cleft lips and palates in developing countries throughout the world as well as within the US. I was selected to do medical records on a mission to Venezuela in the fall of 1998 and have been doing a mission each year since then. I just recently returned from my 13th mission, this time to China. Through my involvement with Operation Smile, I have been honored with opportunities to travel to Venezuela, Kenya, Morocco, India, China, Thailand, Madagascar, and Ethiopia.

When I went on my first mission, I had no idea what to expect. During the first few days of the mission, anyone who wants to have surgery comes to be evaluated. In many parts of the world, children born with facial deformities are treated as social outcasts, as well as facing physical implications such as not being able to eat properly. Oftentimes, they don’t have access to adequate health care, if any healthcare at all. Operation Smile spreads the word through various venues to let people in the area know that a mission will be taking place. Once the mission begins, the patients first come to the medical records station where the volunteers record demographic and background information. Next they are seen by nurses who take a brief medical history and check vital signs, by the anesthesiologists and pediatricians to evaluate whether they are healthy enough for surgery, by a dentist, most often a speech-language pathologist, and finally by the plastic surgeons who assign a surgical priority.

The team leaders then meet and put together the surgery schedule. The goal is that even if a patient isn’t selected for surgery, they at least have the opportunity to be seen by all of the specialties represented on the team. It is difficult when patients have to be turned away because their condition is too severe, they are not healthy enough, or because there simply isn’t time to operate on everyone. So it is important to focus on those we are able to help. Typically, the surgeries take place over the course of four and a half days. On the missions in which I have participated, the number of surgeries has ranged from 77 to 211.

My role on the missions is to coordinate the medical records. All of the team members, who come from all over the world, are volunteers who give their time and skills to help change the lives of the patients, either directly or indirectly. As a non-medical volunteer, I wondered if I’d feel “less important” than those who actually care for the patients, but I haven’t experienced that feeling at all.

Medical equipment is brought in by Operation Smile as the conditions in which we work vary significantly. In Ethiopia, the hospital we worked at had no running water so the surgeons scrubbed in with hand sanitizer, as that was safer than using water that had been collected in dirty buckets. The patients and families all stayed in one large room, some having beds, others mattresses on the floor.

A cleft lip repair can be completed in as little as 45 minutes and the patients’ lives are changed instantly. One young man in Venezuela exclaimed as he saw his new face in a mirror after surgery, “now I am no longer the monster of my village.” In Kenya a young man named John, who had lived most of his life on the streets, had his cleft lip and palate repaired, and soon thereafter went to school for the first time at the age of 13. These are just two stories of renewed life that are part of each and every mission. During a television interview I once saw, Dr. Bill Magee, the founder of Operation Smile said, “these patients go from death to life in 45 minutes.”

All mission volunteers, regardless of their role, are welcomed into the OR to see the life-changing transformations occurring. It is difficult to put into words how powerful it is to witness. Though the volunteers often don’t speak the language of the patients and their families, it’s amazing how much can be communicated non-verbally. As they say, “a smile is worth a thousand words.” Seeing the smiles on the faces of the parents, children, and adults after the surgeries is absolutely heartwarming. In India, the mother of a child kissed the feet of the nurse who brought her child back from the recovery room. In China this last trip, our medical records station was located just across the hall from the pre/post-op ward. As the patients and their families were discharged from the hospital, they would come by our station and wave good-bye with huge smiles on their faces.

The timing of my most recent mission to China couldn’t have been any better. I left just two weeks after the untimely death of my friend and colleague Micki Madland, a long-time physician recruiter and ASPR member. After experiencing such intense sadness, my heart was warmed to have the opportunity to help create new smiles for 77 children and young adults in Zhongshan. Though the days during the missions are long and the many hours of travel are exhausting, I come back with new friends from all around the world, feeling renewed, appreciative of all that we take for granted (such as education and health care), and ready to start planning for my next mission.